MODERN MYSTIC, LLC
Ambulatory Health at Brothers Rd, Santa Fe, NM

License number
New Mexico T-0174411
Category
Ambulatory Health
Type
Mental Health (Including Community Mental Health Center)
Owner
Name: MS. ROXANNE MERCURIO M.A.,L.M.H.C
Title: LICENSED MENTAL HEALTH COUNSELOR
Phone: (505) 231-3786
Address
Address
2213 Brothers Rd, Santa Fe, NM 87505
National Provider ID: 1720445679
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about MODERN MYSTIC, LLC at bizstanding.com

MODERN MYSTIC, LLC

9 Bonito Road  , Santa Fe, NM 87508

Status:
Inactive
Registration:
Sep 26, 2013
State ID:
4822366
Business type:
Domestic Limited Liability Company
Organizer:
Roxanne Mercurio (Organizer)

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